1710.118—Receipt, agent certification and cancellation page.

(a) Format. The receipt, agent certification and cancellation page shall be prepared in accordance with the sample printed herein.
Receipt, Agent Certification and Cancellation Page
purchaser receipt
Important: Read Carefully
Name of subdivision
OILSR number ____________ Date of report ___
We must give you a copy of this Property Report and give you an opportunity to read it before you sign any contract or agreement. By signing this receipt, you acknowledge that you have received a copy of our Property Report.
Received by ____________________ Date ___
Street address
City ______________ State ______________ Zip ___
If any representations are made to you which are contrary to those in this Report, please notify the:
Office of Interstate Land Sales Registration
HUD Building, 451 Seventh Street, S.W.
Washington, D.C. 20410
Agent Certification
I certify that I have made no representations to the person(s) receiving this Property Report which are contrary to the information contained in this Property Report.
Lot __________ Block __________ Section __________
Name of salesperson
Signature ____________________ Date ___
Purchase Cancellation
If you are entitled to cancel your purchase contract, and wish to do so, you may cancel by personal notice, or in writing. If you cancel in person or by telephone, it is recommended that you immediately confirm the cancellation by certified mail. You may use the form below.
Name of subdivision
Date of contract
This will confirm that I/we wish to cancel our purchase contract.
Purchaser(s) signature__________ Date ___
(b) The original and one copy of this page shall be attached to the Property Report delivered to prospective purchasers. Carbon paper may be inserted between the two so that after the purchaser has signed the receipt and the salesman has signed the certification, the copy can be detached and retained by the developer for a period of three years from the date of execution or the term of the contract, whichever is the longer. Upon demand by the Secretary, the developer shall, without delay, make the copies of these receipts and certifications available for inspection by the Secretary or the developer shall forward to the Secretary any of the receipts and certifications, or copies thereof, as the Secretary may specify.
(c) If the transaction takes place through the mails, the cost figures shall be entered and the person most active in dealing with the prospective purchaser shall sign the certification prior to mailing the Property Report to the purchaser. Otherwise, the certification shall be executed in the presence of the purchaser.
(d) The date of Report appearing on the receipt shall be the same as that appearing on the cover sheet of the Property Report.
(e) Notification of cancellation by mail shall be considered given at the time post-marked.